title: Prognostic value of tissue Doppler echocardiographic imaging in elderly patients with acute myocardial infarction.
abstract: BACKGROUND
  The ratio of mitral end-diastolic velocity and mitral annular early diastolic motion velocity (E/e') has predictive value in patients with acute coronary syndromes (ACS). Both E and e' velocities change with age. The prognostic value of E/e' in elderly patients with ACS has not been established yet. The aim of the study was to assess the prognostic significance of E/e' in patients over 65 with ACS.
  
  
  METHODS
  The study involved 168 patients, mean age 79 years. Echocardiography was performed within first 24 hours of ACS. Clinical evaluation, 6-minute walk test, echocardiography and plasma level of NT pro-BNP were performed 12 months later.
  
  
  RESULTS
  Patients, who were still alive after 1-year follow-up had significantly lower E/e' during hospitalization: 11.1 ± 3 versus 15.1 ± 5 (P < 0.05). The optimal cutoff value of E/e' differentiating survivors and nonsurvivors after 12 month follow-up was 12. Initial E/e' was an independent predictor of mortality during 1-year follow-up. E/e' ratio during hospitalization significantly correlated with NT pro-BNP concentration (r = 0.48, P < 0.001) and 6-minute walking distance: (r =-0.32, P < 0.05) after 1-year follow-up.
  
  
  CONCLUSIONS
  (1) In patients over 65 with myocardial infarction, E/e' above 12 is an independent predictor of death during 1-year follow-up. (2) E/e' ratio in acute phase of myocardial infarction correlated significantly with N pro-BNP level and 6-minute walking distance after 1-year follow-up.
authors.affiliation: Bielanski Hospital, ul. Ceglowska 80, Warsaw, Poland Bielanski Hospital, Polish Academy of Science, Warsaw, Poland. snopek@mp.pl
authors.forename: Grażyna
authors.initials: G
authors.lastname: Snopek
authors.forename: Wojciech
authors.initials: W
authors.lastname: Drewniak
authors.forename: Marcin
authors.initials: M
authors.lastname: Borys
authors.forename: Marek
authors.initials: M
authors.lastname: Dabrowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity